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. 2022 Nov;36(11):8340-8348.
doi: 10.1007/s00464-022-09284-w. Epub 2022 May 9.

Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy

Wongi Woo  1 , Bong Jun Kim  1 , Du-Young Kang  2 , Jongeun Won  1 , Duk Hwan Moon  1 , Sungsoo Lee  3
Affiliations

Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy

Wongi Woo et al. Surg Endosc. 2022 Nov.

Abstract

Objective: We aimed to investigate compensatory hyperhidrosis (CH) and recurrence based on an online survey of patients who underwent endoscopic thoracic sympathicotomy(ETS) for palmar and/or axillary hyperhidrosis.

Methods: We enrolled 231 patients who underwent ETS for palmar and/or axillary hyperhidrosis from January 2008 to April 2021. Patients responded to an online questionnaire regarding CH and recurrence, their electronic medical records were reviewed. Logistic regression was performed to find the risk factors related to CH and recurrence.

Results: The median time of survey from surgery was 20 months. Although 94% of patients were satisfied with the surgery, 86.1% experienced CH; of them, it was severe in 30.7%. Three months after surgery, there was no long-term change in the severity of CH. The development of CH showed a close relationship with age of 20 years or more (OR: 2.73). Recurrence occurred in 44(19.0%) patients, and the use of anti-adhesive agents was a significant preventive factor against recurrence after ETS (OR: 0.42).

Conclusions: We observed that CH and recurrence after ETS for palmar and/or axillary hyperhidrosis were relatively common. Age at the time of surgery was associated with CH, and the use of anti-adhesive agents showed to lower the risk of recurrence after ETS.

Keywords: Compensatory hyperhidrosis; Endoscopic thoracic sympathicotomy; Hyperhidrosis; Online survey; Recurrent hyperhidrosis.

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Conflict of interest statement

Drs. Wongi Woo MD, Bong Jun Kim MD, Du-Young Kang MD, Duk Hwan Moon MD, Sungsoo Lee MD, PhD and Ms. Jongeun Won, BBA have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
The satisfaction score of patients; Patients’ satisfaction of endoscopic thoracic sympathectomy in five categories; very good, good, moderate, poor, and very poor
Fig. 2
Fig. 2
Regional distribution of compensatory hyperhidrosis (CH); The regional distribution of compensatory hyperhidrosis by number of areas involved
Fig. 3
Fig. 3
The temporal change of HDSS score in Compensatory Hyperhidrosis (CH); HDSS: Hyperhidrosis disease severity score[14], NA: not available. The proportion of compensatory hyperhidrosis severity using HDSS which measured in three different periods; 1 month, 3 months, and 12 months
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